Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control

Abstract

INTRODUCTION: Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers. METHODS: Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities' approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice. RESULTS: Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person's violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities. CONCLUSION: Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when communicating with these communities about prevention and control. These research findings might also be of value to national and provincial agencies in charge of decreasing the rates of Chagas disease among indigenous populations.Fil: Dell Arciprete, Paula. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Braunstein, Jose Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Touris, María Cecilia. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud “Dr. C.G. Malbrán”. Instituto Nacional de Parasitología “Dr. M. Fatala Chabén”; ArgentinaFil: Dinardi, Matias Andres. Universidad Nacional de Tres de Febrero; ArgentinaFil: Llovet, Ignacio Diego. Universidad Nacional de Luján. Departamento de Ciencias Sociales; ArgentinaFil: Sosa-Estani, Sergio Alejandro. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorio e Instituto de Salud “Dr. C.G. Malbrán”. Instituto Nacional de Parasitología “Dr. M. Fatala Chabén”; Argentin